This page has no animated pictures, no blinking, no scrolling text and no bright white, on purpose. If you're reading it in the middle of an attack, I've got you. Turn your screen down and come back later for the rest.

For eleven years I've been a commercial photographer in Seattle. Catalog work, mostly: shoes, coffee makers, a lot of salmon. The darkroom was always my favorite place in the world. Quiet, dim, just the amber safelight and the sound of the timer and the smell of the chemicals.

These days I spend a lot of time in dark rooms for a different reason.

My name is Philip Rosemond. I'm 34. I've had migraines since I was fourteen, and for the last five years they've come two to six times a month. I made this page in 1997, during a stretch when I was losing about a week out of every month, because I wanted to find other people who understood. I've found a lot of you. Almost 27,000 visits later, this is still the most useful thing I've ever put on film or anywhere else.

It's not "just a headache"

I'm not a doctor, so please take this as one patient's understanding, and see yours.

A migraine is a neurological condition, and the headache is only one part of it. A typical migraine headache is on one side of the head, throbbing, moderate to severe, and gets worse when you move around. It usually comes with nausea, and with sensitivity to light and sound (sometimes smells too). An attack can last anywhere from a few hours to three days.

Some of us, maybe one in five, also get an aura beforehand, usually something visual like flashing zigzag lines or a spreading blind spot, that lasts somewhere around twenty minutes to an hour before the pain starts. I'm one of those. I've tried to describe mine, and the rest of an attack from start to finish, on a separate page: What an Attack Looks Like from Inside.

Migraine is common. Something like three times as many women get migraines as men, but plenty of us men get them too, and we're often the last to admit it. It tends to run in families. My mother had "sick headaches" her whole life and lay down with a washcloth over her eyes. Nobody ever called them migraines.

Triggers

A trigger is something that can set off an attack in someone who's prone to them. Everybody's are different, and often it's a few things stacking up. Common ones:

• stress, and also the let-down after stress (hello, Saturday-morning migraine)
• skipped meals
• too little sleep, or sleeping in
• alcohol, especially red wine, for some people
• certain foods for some people, like aged cheese, cured meats or MSG
• weather changes (Seattle, why)
• bright or flickering light: sun on water, fluorescent tubes, a studio strobe going off in your face all day
• strong smells, like perfume or cleaning products
• hormonal changes, for many women

The best tool I ever used for finding mine was a headache diary. For three months I wrote down every attack: date, time, how bad, what I ate, how I slept, the weather, what I took and whether it helped. Patterns jumped out that I'd never have noticed. For me it's skipped lunches plus long strobe shoots plus a drop in the barometer. Now I eat lunch like it's my job, and I wear dark glasses between flashes. My clients think I'm very Hollywood.

Treatment, in general

Please talk to a doctor about this part. I won't tell you what to take, because what works is very individual, and some medicines aren't safe for some people. Here's what I wish I'd known years sooner:

• See a doctor, and if the first one shrugs, see another. I lived on drugstore painkillers for ten years before anybody took me seriously. A neurologist or a headache specialist may know more options.
• There are prescription medicines made specifically for migraine now. A newer group of drugs called triptans started coming out in the early nineties, and there are several of them available now. For many people, including me, they can stop an attack if taken early. They're not right for everyone, which is why you need a doctor.
• If you get a lot of migraines, ask about prevention. There are daily medicines that can cut down how often attacks come. Mine went from about six a month to two.
• Watch out for rebound headaches. Taking pain medicine for headaches too many days a week can actually cause more headaches. I did this for years without knowing. Ask your doctor how often is too often for what you take.
• The unglamorous stuff helps too. Regular sleep, regular meals, water, a quiet dark room, an ice pack on the back of the neck.

To the people who love us

When I cancel on you, I'm not being dramatic. When I'm in the bedroom with the blinds taped shut, please don't open the door to ask if I'm okay; a note slid under it is perfect. And when I come out the next day slow and foggy and a little dumb, that's the migraine hangover. It passes. Thank you for waiting it out with me. (Especially Anne, who has been doing it for nine years.)

Resources

• The National Headache Foundation and the American Council for Headache Education both have information for patients, and can help you find doctors who specialize in headache.
• Your library. There are several good books on migraine for patients now. Read them lying down.
• Other migraine people. There are e-mail lists and newsgroups where people trade notes. Just remember nobody there is your doctor, including me.

Write to me if you'd like. I answer everything eventually, on good days.
[email protected]

Visitors since July 1997:

Last updated Saturday, September 18, 1999, on a clear day.
© 1997-1999 Philip Rosemond. This page is about my own experience and is not a substitute for medical care.